A tale of two clinics — the treatment of infertility with Chinese medicine or Western medicine

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A tale of two clinics – the treatment of infertility with Chinese medicine or Western medicine

An infertility clinic in China is worlds away from an infertility clinic in the West in just about every way but one: the desperation to have a child where nature has failed to provide. This human response is the same everywhere. The biological imperative to reproduce has no cultural boundaries.

The treatment offered by an infertility clinic in a traditional Chinese medicine (TCM) hospital of the early twenty-first century is basic and minimally-invasive: herbs are prescribed; acupuncture or Qi Gong exercises may be recommended; lifestyle or dietary changes are advised if necessary; pathology tests may be ordered for analysis of blood or semen; surgery may in some cases be recommended. The patient drinks a decoction of herbs twice every day (probably for several months), returns to the clinic weekly, fortnightly or monthly to see if the prescription needs changing and is encouraged to lead a healthy life.

CASE HISTORY – THE WONGS

One couple I remember distinctly is the Wongs, who visited Dr Chong one day when I was sitting in on her morning clinic. Dr Chong, a gynecologist specializing in infertility, works in a large municipal hospital in south China. She sees dozens of patients each morning in her tiny room, furnished with just a table, two benches and one light bulb. The waiting patients huddle around the door and often listen in on consultations. There is little privacy here, even though patients are discussing details of their menstrual cycle and sex life.

The Wongs were country folk who seemed extremely nervous about their visit to the big city hospital. They had been married for 4 years but had not had a child. When asked about her menstrual cycle, Mrs Wong told us it was irregular and long. I noticed that she was slightly plump and somewhat more hairy than the average Chinese woman, and I wondered if she had polycystic ovary syndrome. But Dr Chong was busy asking her about her diet, digestion and general health. After feeling the pulses at her wrist and looking at her tongue, the doctor prescribed a formula of herbal medicines, which were to be taken over the next 2 weeks. The herbs, she explained, would encourage Mrs Wong’s periods to come more often. Mr Wong was sent for a semen analysis.

The next time the Wongs came to the clinic, they seemed more relaxed and greeted us with a bag of delicious strawberries from their small farm – no doubt one of the main reasons I remember this couple in particular. Dr Chong had the not too welcome news for Mr Wong that his sperm count was low and that the sperm motility was poor. Dr Chong asked him some more questions, discovering that he suffered chronic lower back pain and had a low libido. She wrote out a script for herbs for him as well.

Mrs Wong reported that the herbs she had been taking had provoked the production of more clear vaginal discharge for several days. Dr Chong looked pleased.

The couple came in from their farm to visit the clinic once a month after that. Apart from these visits and drinking a cup of herbs twice a day, their infertility treatment intruded little on their lives. They both said they felt more energetic and healthy while taking the herbs, and Mr Wong’s libido improved. But after 4 months, they were becoming frustrated that they had still not conceived and the pressure from their parents, anxious to meet their one permitted grandchild, was increasing. Dr Chong pointed out that their progress had in fact been very good. Mrs Wong’s menstrual cycle was much shorter (closer to 4 and a half weeks now compared to the 6 or 7 weeks at the outset). This, plus an improved sex life, meant greatly increased chances of conceiving.

I was no longer in China when Mrs Wong’s pregnancy was announced – but I heard the news on the grapevine. After 6 months of daily treatment, the Wongs had achieved their goal and 9 months later they were the thrilled parents of baby Chen. Two sets of grandparents could relax!

The approach of the assisted reproduction technology (ART) or in vitro fertilization (IVF) clinic in the West, on the other hand, is more sophisticated and the procedures are quite involved. The specialist will prescribe drugs and perhaps perform surgery. He or she will rely on the expertise of nursing staff to administer injections and take blood samples, radiologists to perform ultrasounds, embryologists to monitor fertilization of the egg by the sperm and embryo development in the laboratory. The patient’s visits to the clinic are timed around the cycle and are quite frequent during the 4–6 week program, during which time they will receive medication, be monitored for their response and have procedures such as intrauterine insemination, egg collection or embryo transfer carried out.

CASE HISTORY – THE SMITHS

I met Madeline Smith briefly when she sought help for coping with the stress she was experiencing during her IVF attempts. Her story is one that we typically hear in the West. At age 39, she and her 40-year-old husband Frank, after trying unsuccessfully for a year to conceive, had decided they had better get some help. They were worried they may have left it a bit late. A specialist at a state-of-the-art IVF clinic diagnosed Madeline with polycystic ovary syndrome after seeing an ultrasound of her ovaries and blood test results. Because of her infrequent ovulations and her age, he suggested they embark on an IVF program without delay. Madeline, a health and fitness enthusiast, was reluctant but in her eagerness to have a baby, she decided she would do whatever it took. She injected the drugs in her belly every day, visited the clinic for ultrasounds and blood tests regularly, complained about the headaches and abdominal discomfort and cried more than usual (this is the point at which she came to my clinic for acupuncture to help relieve the side-effects).

But when it came time to ‘harvest’ her eggs she was sedated and the doctor, wielding a needle attached to a pump removed a bumper crop of seven from her ovaries. The embryologist then introduced the sperm (freshly donated by a rather nervous Frank in a back room) into the Petri dish, the eggs all fertilized and four of them developed into embryos. Two were transferred back to Madeline’s uterus and two were frozen for the future.

After an interminable wait, Madeline had blood taken for a pregnancy test! Then, after what seemed another endless wait, came the phone call: ‘I’m sorry your test is negative.’ After such a huge emotional and physical investment, this news was profoundly disappointing.

It took a while for Madeline and Frank to recover from the experience, but in a couple of months they were back at the IVF clinic. They opted for a so-called natural (no drugs) cycle for the transfer of their frozen embryos. Although she was not taking drugs, Madeline still had to attend the clinic for frequent blood tests and ultrasounds. Being more familiar with the process and not having to deal with any drug side-effects she coped much better. Even the failure of one of her frozen embryos to thaw properly at the time of transfer did not dampen her optimism too much – optimism that was well placed because this last embryo was the one that made it. Her pregnancy was not uneventful and baby Rory was born early and tiny, but he survived and Madeline and Frank were the proudest parents on the ward.

Related posts:

  1. Assisted reproduction technology and in vitro fertilization
  2. Blockage of the Fallopian Tubes
  3. Gynecologic disorders which can cause infertility
  4. Traditional Chinese medicine treatment of the IVF patient

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Jul 11, 2016 | Posted by in PEDIATRICS | Comments Off on A tale of two clinics — the treatment of infertility with Chinese medicine or Western medicine

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